The January 2015 CPT® Assistant is jam-packed with advice on 2015′s molecular pathology code updates. Get the inside scoop on revisions made to the gene table to include claim designators for Tier 2 Molecular pathology codes. Find out how the new section in CPT® 2015 for genomic sequencing procedures (GSPs) and other molecular multi analyte assays impacts reporting of 21 new codes to describe gene panel analysis.
Reviewing the latest issue will also improve your understanding of how to appropriately report percutaneous vertebroplasty and vertebral augmentation codes as well as aqueous shunt procedures and visual field assessment. Make the most of SuperCoder.com’sCode Connect code and keyword search to keep your skills up to date on these topics:
- Aqueous Shunt Procedures and Visual Field Assessment: 66180, 67255, 66185, 0378T-0379T
- Maternity Care and Delivery: 99201-99205, 99211-99215, 99241-99245, 99281-99285, 99384-99386, 99394-99396
- Molecular Pathology Update: 81246, 81288, 81292, 81313, 81400-81408, 81410-81471, 81445-81455, 81479, 81500-81599, 0006M-0008M
- Percutaneous Vertebroplasty and Vertebral Augmentation: 20225, 22310-22315, 22325, 22327, 22510-22515, 22520-22525, 22526-22527, 22899, 72291-72292, 0200T-0201T.
433.10 leads to more choices.
When your cardiologist performs angiography, catheterization, or stent procedures in the carotid artery for conditions such as stenosis, you’ll need more information to accurately report the condition under ICD-10.
You should be ready to implement these changes when ICD-10 goes into effect on Oct. 1, 2015.
ICD-9 offers two codes for carotid artery stenosis:
- 433.10 — Occlusion and stenosis of carotid artery without cerebral infarction
- 433.11 — Occlusion and stenosis of carotid artery with cerebral infarction.
But each of these codes grows to four different code choices under ICD-10.
Question: When the otolaryngologist performs a scope in the office and also gives a shot (using 96372 for administration and a separate code for the medication), is there any reason to put a modifier on the administration 96372 code?
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you to revalidate your enrollment information—but practices that haven’t yet done that are probably hearing from their MACs by now.
Pay attention to time documentation for correct use.
If your urologist does advance care planning for patients, you will likely make use of two new codes that CPT® added for 2015. Read on to learn about the new additions and the lingering questions experts have about how you’ll use these codes.
Add 99497-99498 to Your Coding Arsenal
CPT® 2015 adds two new advance care planning codes: 99497 (Advance care planning including the explanation and discussion of advance directives such as standard forms [with completion of such forms, when performed], by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member[s], and/or surrogate) and add-on code +99498 (... each additional 30 minutes .…).
According to CPT® 2015,
Plus: CMS releases 2015 therapy cap amounts
If your payer is performing a pre-payment audit of your claims, the MAC will typically ask you for additional documentation. In the past, some MACs would say you had 30 days to submit the documentation, while other insurers might not have given you a timeframe. CMS has cleared the air on this topic, confirming that you have 45 days to respond to an Additional Documentation Request (ADR), CMS says in MLN Matters article
Get ready for new options later this year
When your lab performs a screening drug test, you can’t expect to get the same diagnosis code every time.
Instead, the reasons clinicians order a drug screen are as varied as the drugs themselves — and your code choices are about to get even more varied when ICD-10 goes into effect on Oct. 1.
Check Out These Crosswalk Options
Question: Our podiatrist visited an established patient at a nursing home but noted an infection and tinea pedis not previously seen. His notes describe an I&D on the left hallux, and he also wrote orders for the tinea pedis. Additionally, he performed nail care 11721 with Q8. How should I code this encounter? Please share some info on the I&D procedure.
Take HITECH lessons to heart, and protect your bottom line.
They might look like a barrage of random numbers, but two recent reports about HIPAA breaches actually contain nuggets of wisdom that you can use to protect your patients’ private health information.
Make sure you apply the following important lessons from the Health Information Technology for Economic and Clinical Health (HITECH)-mandated reports to keep your general surgery practice out of the penalty zone.
Contact with and suspected exposure codes are also relevant in Ebola outbreaks
Ebola Virus cases have been everywhere in the news recently and focusing a lot of attention of emergency departments. The medical team has to get the diagnosis right to appropriately treat the patient and prevent widespread exposure to the community. As a coder, you must get the diagnosis code right, as well, for both tracking purposes and accurate payment for services rendered.
Consider this scenario: A 42 year-old health care worker comes to the ED because of a low grade fever. He had recently returned from a medical mission where he was caring for patients who had Ebola Virus Disease (EVD). There are no other symptoms and the patient is medically stable. Based on current Centers for Disease Control and Prevention and your local health department’s guidelines, the patient will be admitted to a special quarantine unit. What diagnosis codes should you use for the ED encounter?